O-13 Trends in diabetic ketoacidosis in Guyana: a two-year review of clinical profiles and outcomes at Georgetown Public Hospital Corporation (2023–2024)

Methods: A retrospective cross-sectional review was conducted. Adults aged ≥18 years with documented type 1 or type 2 diabetes and confirmed DKA were included; gestational and other diabetes types were excluded. The study sample comprised 151 patients. Demographic, clinical, biochemical, precipitating, and outcome data were abstracted using anonymized identifiers and analyzed descriptively. Group comparisons used chi-square tests and time to anion gap closure was assessed using Kaplan–Meier analysis.

Results: Of 151 DKA cases, 20 (13.2%) had type 1 diabetes and 131 (86.8%) type 2. Type 1 patients were significantly younger, with 55 % aged <29 years compared with 10 % of type 2 patients (P<0.001). Sex and ethnicity distributions were not different. Vomiting was the most common presenting complaint in type 1 patients, whereas type 2 patients more frequently reported generalized weakness, shortness of breath, and vomiting. Medication nonadherence was the leading precipitant in both groups (type 1: n=16; type 2: n=65), followed by newly diagnosed diabetes and infection. Biochemical severity at presentation was not different, although type 1 patients showed a trend toward a higher anion gap (25.7±7.3 vs 22.3±7.1 mmol/L; P=0.055). Median length of stay was 5 days in both groups (P=0.402). Mortality was low and comparable (10.0% vs 6.9%, P=0.641). Time to anion gap closure did not differ by diabetes type (log-rank P=0.59).

Conclusion: This study demonstrates a high burden of adult DKA at GPHC, predominantly affecting patients with Type 2 diabetes, who were older and commonly presented with modifiable precipitating factors. These findings highlight prevention-focused strategies as the greatest opportunity to reduce DKA burden.